Provider Demographics
NPI:1942973516
Name:DOBARIA, DUSHYANT GOPAL (MD)
Entity Type:Individual
Prefix:
First Name:DUSHYANT
Middle Name:GOPAL
Last Name:DOBARIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 JEFFERSON AVENUE
Mailing Address - Street 2:SUITE F 150
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103
Mailing Address - Country:US
Mailing Address - Phone:901-448-4454
Mailing Address - Fax:901-448-1248
Practice Address - Street 1:865 JEFFERSON AVENUE UNIVERSITY OF TENNESSEE
Practice Address - Street 2:SUITE F 447
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103
Practice Address - Country:US
Practice Address - Phone:901-287-5265
Practice Address - Fax:901-287-5062
Is Sole Proprietor?:No
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program